C ONFLICTOS SOCIALES DESARROLLADOS EN MÁS DE UN DEPARTAMENTO

There little is known about the impact of theoretical model and/or implementation strategies used in immigrant and refugee youth programming (Tyrer & Fazel, 2014). The most common forms of resilience-based programming in the literature are school-based, community-based, culturally-adaptive, creative-expressive, social justice, and trauma- informed programming. Readers should note that programming is dynamic and often integrates multiple forms of the examples listed above. In addition, recent studies have highlighted the importance of multi-modal or comprehensive services to refugees and their families (Ellis, Miller, Abdi, Barrett, Blood & Betancourt, 2013) as multimodal services, “aim to concurrently address issues of psychological functioning, social and cultural adaptation, physical health and ongoing psychosocial difficulties” (Tyrer & Fazel, 2014, p. 9). Adaptive multi-modal services address the complexities of the refugee or asylum-seeking experience and difficulties that newly-arrived children and youth may face. Limitations within this body of research identify the gaps in literature for immigrant and refugee youth programming.

The current study focused on the types of interventions in the literature that positively impact resilience among immigrant and refugee youth to align with the Intercultural Program’s goals and outcomes. A resilience-based program or intervention must be able to successfully address risks that pose a threat to a child’s well-being, as well as facilitate the process of obtaining resources or building capacities to overcome risks (Ungar, Russell, & Connelly, 2014). Therefore, effective resilience programs need to be multifactorial, multisystemic, and multilevel, encompassing numerous levels of

Furthermore, researchers suggest that resilience-based programming is most effective when delivered through a cumulative protection model. The cumulative protection model works to build multiple resources simultaneously in order to promote resilience and help prevent mental health conditions (Lin, Sandler, Ayers, Wolchik & Luecken, 2010; Sandler, Ayers, Wolchik, Tein, Kwok, Haine et al., 2003). A cumulative protection model can also be employed in a multitude of settings, such as community- based interventions, group work, and individual psychotherapy.

The next most successful resilience model for immigrant and refugee youth programming is the protective-reactive model (Fergus & Zimmerman, 2004). The protective-reactive model is used when a protective factor diminishes, but does not completely eliminate, the negative outcome of risk. In the absence of the protective factor, the relationship between risk and negative outcomes is strengthened. Therefore, the difference between the potential outcome without the protective factor and actual outcome with the protective factor is the resilience gained as a bi-product of the presence of the protective factor.

Unsuccessful resilience-based programs are those that are too over-generalized and do not offer access to resources that are contextual and meaningful to varying

populations (Ungar et al., 2014). Universal programming assumes that youth face similar risks despite differences in identified gender, race, culture, sexual orientation,

background, class, and other experiences (Spence & Shortt, 2007). Luthar, Cicchetti, and Becker (2000) also advise against resilience-based interventions that are overgeneralized or one-dimensional when serving various cultural populations because they lack the necessary components of community and culture that most promotes resilience among

immigrant and refugee youth. In addition, universal programs risk being shaped by the dominant society and, therefore, practices have the potential to disempower minority populations.

Resilience-based interventions implemented in the 1990s and 2000s addressed the needs of children that demonstrated acute risk of unhealthy development due to increased levels of adversity. Unfortunately, each of these interventions is individualistic and fails to measure how resilience is perceived among varying cultures and contexts. The literature refers to the following examples: Responsive Advocacy for Life and Learning in Youth (RALLY; Noam & Hermann, 2002); The Life Skills Training Program (Botvin & Griffin, 2002); and Resourceful Adolescent Program (RAP; Shochet & Ham, 2004). These interventions aim to increase participant’s assets and access to resources in an effort to mitigate risks such as psychopathology, substance dependency, violence, and heightened anxiety (Zolkoski & Bullock, 2012). These examples illustrate the first-wave of resilience-based programs that were designed around research that promoted resilience as an individual trait.

School-Based Programming

The literature suggests that most immigrant and refugee youth programming is delivered at school because schools are uniquely positioned to facilitate early

interventions for children and youth (Tyrer & Fazel, 2014). Ungar et al. (2014) states that, “the best school-based interventions appear to be collaborative, multisystemic and culturally and contextually relevant, responding to what children themselves say they need” (p. 71). Schools are able to link youth to opportunities for academic success,

efficacy and self-esteem (Ungar et al., 2014; Ungar et al., 2017). In addition, school- based interventions delivered in a safe setting offer individuals and families access to non-stigmatizing services (Tyrer & Fazel, 2014). Faculty and staff play a critical role in developing student’s resilience by promoting a sense of leadership, actively preventing bullying and discrimination, providing access to free or subsidized lunch programs, and implementing culturally relevant curriculum (Hinrichs, 2010; Kana‘iaupuni, Ledward, & Keohokalole, 2011; O’Brennan & Furlong, 2010; Ripski & Gregory, 2009; Ungar et al., 2017).

Community-Based Programming

Developing a sense of belonging and perceived community support are themes found in community-based interventions throughout the literature (Pieloch, McCullough, & Marks, 2016). A majority of the recent forced migrant population that has relocated from African, Middle Eastern, and Asian countries come from collectivist cultures, many of which encourage the adoption of group identity over the self. The collectivist value system heightens the level of negative impact that discrimination and xenophobia may have on newly-arrived children and youth (Weaver & Hertz, 2008). As a mitigating factor to this social risk, collectivist cultural values and norms should be integrated into resilience-based interventions in an effort to increase social capital. One research study concluded that refugee youth from Somalia, Burundi, Liberia, and South Sudan all reported feelings of connection, belonging, and shared experience through increased community engagement (Pieloch, McCullough, & Marks, 2016). These findings illustrate that effective services for newly-arrived children and youth from collectivist cultures should work to enhance community integration and belongingness.

Culturally-Adaptive Programming

Community-based services that integrate cultural context promote resilience among intercultural youth (Ungar et al., 2014). An example of a culturally-adaptive resilience intervention is a Day in the Life International Youth Resilience Research Methodology (DITL; Cameron, Lau, & Tapanya, 2009). DITL aims to assess resilience among youth who have experienced significant relocations, such as refugee or asylum status, across the globe. DITL can help to bring awareness to the unique strengths that immigrant and refugee children and youth contribute to their host country. A second example is Wrapped in Angels, an arts-based intervention that aims to build resilience across different cultures through the creation of a quilt (McVeigh & Oliveri, 2018). Wrapped in Angels is grounded in the relational model and encourages participants to utilize increased connectedness as a protective factor against risk (McVeigh & Oliveri, 2018).

Maintaining a connection with one’s cultural heritage or ethnic identity also promotes the wellbeing of newly-arrived children and youth. Ungar et al. (2014) found that youth who report higher rates of connectedness to their culture and ethnicity

experienced lower rates of drinking, poor health, and/or suicidal thoughts. Ethnic identity combines cultural, affiliative, and subjective dimensions of identity and is commonly linked to an attitude of self-empowerment, as opposed to a feeling of victimization or self-denigration (Oetting & Beauvais, 1991 as cited in Kulis et al., 2002); however, when identity and culture have been disempowered by the dominant group, one may perceive a group’s ethnic identity as negative. Culturally adaptive and creative interventions can aid

the restoration of hope and connection to ethnic identity for migrant children and youth (Bemak & Chung, 2017).

Further studies found that students who possess a strong ethnic identity are able to better cope with experiences of racism (Lee, 2005; Sellers, Copeland-Linder, Martin & Lewis, 2006). Maintaining connection to ethnic cultural practices has been proven to promote resilience among Burundian, Liberian (Weine, Merrill, Ware, Tugenberg, Hakizimana, Dahweih, Currie, Wagner & Levin, 2013), Afghani (Kanji & Cameron, 2010), and Somali refugee children living in the United States and Canada (Rousseau, Said, Gangne & Bibeau, 1998; Pieloch, McCullough, & Marks, 2016). On average, ethno-racial minorities who possess positive coping skills earn better grades, are less violent at school, and experience improved psychosocial wellbeing (Ungar et al., 2017). Creative-Expressive Programming

Practitioners and researchers are more commonly turning to arts-based

approaches to encourage multiple forms of expression, and to access art’s therapeutic, restorative, and empowering qualities (Denov & Shevell, 2019). Creative-expressive techniques, such as music therapy, creative play, drama, and drawing, draw on a wide range of therapies and modalities and are most commonly used in multi-modal

interventions or approaches designed to address mental and emotional health

simultaneously (Tyrer & Fazel, 2014). For example, art activities used with children and youth in refugee camps have engaged participants in ‘constructed action’ (Andemicael, 2011). Art through action can lead a child to personal growth and fulfillment; “creating artwork offers a form of self-expression that may be cathartic, revealing, meaningful, and therapeutically beneficial” (St Thomas & Johnson, 2007, p. 93). Therefore, creative

expression should emphasize process, experience, and personal meaning to create resources for children and youth.

Resilient themes are observed through art and are often expressed by unstructured role playing and body-centered activities (St Thomas & Johnson, 2007). Such free play allows space for physical expression and the telling of one’s story. These interventions are particularly meaningful for newly-arrived children and youth because of cultural and language barriers that may impede other forms of communication. Through art and other expressive mediums, children are more easily able to communicate and express

themselves (Denov & Shevell, 2019). “Children’s drawings are recordings of their vitality and life, not only the art itself but also its symbolic reference to events and objects in the world of the child” (St Thomas & Johnson, 2007, p. 70).

Social Justice Programming

Immigrants, migrants, refugees, and asylees are subjected to negative judgements about their immigration status through imposed stereotyping, discrimination, xenophobia, racism, and cultural rejection (Santiago & Smith, 2019). The imposition of white culture in Western society stunts the development of ethnic pride in younger generations of immigrants and results in the disengagement of immigrant communities (White, 2018). This inequitable social environment can lead to feelings of isolation from the dominant group.

Social justice group leaders create social change in their work with diverse populations. UNICEF (2019) advocates for clinical and community-based interventions with newly-arrived children and youth that, “combat xenophobia, discrimination, and

programs” (Santiago & Smith, 2019, p. 112). Addressing race, power, and privilege is a crucial component to working with newly-arrived migrants in Western society and fostering resilience. To combat oppression, discrimination, racism, and xenophobia, a critical lens needs to be used when engaging with newly-arrived children and youth to better empower communities of color and differing cultures.

During the multicultural movement of the 1990s, group work was a therapeutic intervention used to embrace differing world-views, values, behaviors, and multicultural identities (DeLucia-Waack, 1996 as cited in Singh & Salazar, 2010). Group-based interventions can help to increase social inclusion and integration. Support groups for youth who experience discrimination in schools have been proven to increase feelings of belongingness and academic performance among participants (Toomey & Russell, 2013; Ungar et al., 2017). As group work developed, modalities have been used to address racial and cultural prejudice through community-building and courageous conversations; however, it should be noted that the group environment may manifest oppression and require the group to address social privilege, race, and discrimination (Singh & Salazar, 2010). As an example, a group with a white facilitator and members of color may cause group members to feel unsafe or unable to freely participate in the group. This systemic and cultural issue can be addressed through courageous conversations about race,

systemic oppression, and privilege in an effort to create safety in the group and empower members of color (Singleton, 2015). In order to facilitate courageous conversations, group norms need to be agreed upon by all members and facilitators must be able to respectfully hold space for conversations around privilege and oppression (Singleton, 2015). Social justice and group-based work can influence societal change or an

individual’s social behaviors that perpetuate oppression and discrimination. This is why a social justice orientation positively impacts community-based interventions for newly- arrived children and youth.

Trauma-Informed Programming

Many of the interventions designed for immigrant and refugee populations in the literature focused on verbal processing of past events and the treatment of PTSD or other trauma-related diagnosis. In a systematic review of school and community-based

interventions for refugee and asylum-seeking children, results indicated that the majority of interventions focused on past traumatic events (Tyrer & Fazel, 2014). Through these trauma-informed interventions, “significant improvements were seen for depression, anxiety, PTSD, functional disturbances, and peer problems” (Tyrer & Fazel, 2014, p. 9). The primary evidence-based modalities used in trauma-informed interventions were CBT (Cognitive Behavioral Therapy), TF-CBT (Trauma Informed Cognitive Behavioral Therapy), NET (Narrative Exposure Therapy; Tyrer & Fazel, 2014), and CBITS (Cognitive Behavioral Intervention for Trauma in Schools; Kataoka, Stein, Jaycox, Wong, Escudero, Tu & Fink, 2003). Another study conducted on the ShifaME program in Lewiston and Portland, Maine tested the TST (Trauma Systems Therapy) model in school-based clinical work with groups and individuals and found positive results (Ellis et al., 2013). In fact, TST is the first multi-tiered model psychosocial intervention

encompassing the spectrum of prevention to treatment for those in need of mental health services, such as community integration and resilience and child resilience (Ellis et al., 2013).

Although trauma and related mental health conditions continue to be a concern among newly-arrived youth, other psychological stressors and community fracturing play an important role in preventing the development of negative mental health outcomes (Ellis et al., 2013). Therefore, trauma interventions will not holistically treat the wide range of stressors that newly-arrived children and youth faces. In addition, it is important to note that trauma is not recognized by all cultures, and practitioners should first

consider the community’s needs before intervening.

Psychosocial wellbeing for newly-arrived children and youth requires therapeutic treatment to impact both inner and outer worlds in an effort to regenerate a lost sense of self, belonging, and autonomy (Kohli & Mather, 2003). Maslow’s (1954) hierarchy of needs states that, “mental health interventions should be preceded by interventions focused on engendering belongingness” and belongingness should be preceded by the establishment of safety (Mitschke, Praetorius, Kelly, Small & Kim, 2017, p. 590). Therefore, trauma-informed interventions among newly-arrive children and youth must be proceeded by the establishment of basic needs and safety in order to tackle emotional and intellectual imbalances.

Summary

In summary, interventions currently used with newly-arrived children and youth may focus on a single trauma or be multi-modal and focus on a range of environmental and social issues (Tyrer & Fazel, 2014). Due to the relatively unexplored field of immigrant and refugee youth programming, options for interventions are limitless. Resilience-based interventions that incorporate a participant’s ethnic and cultural background are more effective than universal programs that dismiss contextual factors.

Current resilience research highlights the importance of creating multidimensional resources that are meaningful to the individual in order to increase resilience and overcome risk. Resilience-based interventions help individuals overcome risks by providing internal and external access to meaningful resources, protective factors, and assets.

Community-based and cultural interventions should be adaptable and

multidimensional in order to enhance an individual’s ethnic identity and reduce migrant stress. Newly-arrived children and youth’s sense of belongingness is increased through culturally-adaptive programming that helps to alleviate feelings of isolation post- migration. Interventions that promote social justice and creative expression can help to increase the wellbeing of newly-arrived children and youth who face social stressors such as discrimination, identity transformations, and acculturative stress due to post-migration.

Children and youth who have experienced persecution, extreme violence, and/or political turmoil in their home countries are at risk of experiencing trauma and

developing mental health conditions, such as PTSD (Ungar et al., 2017), during post- migration. Therefore, communities and practitioners need to assess a participant’s trauma history and foster a connection to one’s ethnic identity in order to promote wellbeing and utilize trauma-informed interventions to treat and prevent mental health conditions.

Finally, universal approaches to immigrant and refugee youth programming is ineffective. Resilience-based programs should be multi-dimensional and encourage a holistic assessment of a person’s social ecology, culture, context, and individual